Caregiving styles and attachment orientations in couples facing advanced cancer

Objective This study examines associations between caregiving styles and caregivers' and patients' attachment orientations among couples facing advanced cancer. Four caregiving styles were examined: proximate, sensitive, controlling, and compulsive. Method A total of 110 patients with advanced gastrointestinal or lung cancer and their spouse caregivers were recruited. Measures included: the Experiences in Close Relationships Inventory, the Caregiving Questionnaire, and the Demand Subscale from the Caregiving Burden Scale. Results Caregivers reported high levels of proximate and sensitive caregiving and moderate levels of controlling and compulsive caregiving. Hierarchical regressions were conducted to examine the contribution of caregivers' and patients' attachment orientations to each caregiving style while controlling for caregiving demands. Both caregiving proximity and sensitive caregiving were negatively associated with caregivers' avoidant attachment. Controlling caregiving was positively related to caregivers' avoidant and anxious attachment orientations. Compulsive caregiving was positively associated with caregiving demand and caregivers' attachment anxiety. In addition, compulsive caregiving was positively associated with patients' attachment avoidance and negatively associated with patients' attachment anxiety. Conclusions The study demonstrated two clusters of ways to provide care: other-oriented and self-oriented. The study revealed that both patients' and caregivers' attachment orientations contributed to caregivers' patterns of caregiving. Insecure attachment orientations and resulting couple interaction patterns of 'demand-withdrawal' and 'avoidance-pursuit' are potential sources of distress that may benefit from exploration in psychotherapeutic interventions for couples facing advanced cancer.